PTCBA联合DCB扩张术治疗冠状动脉分叉病变的疗效及对患者血流TIMI分级的影响  

Effect of percutaneous transluminal coronary angioplasty combined with drug coated balloon dilation in the treatment of coronary bifurcation disease and its effects on patients'blood flow TIMI grade.

作　　者：李雪锋 廖春华 邹云新 徐璧江 杨浩祺 LI Xue-feng;LIAO Chun-hua;ZOU Yun-xin;XU Bi-jiang;YANG Hao-qi(Department of Internal Medicine-Cardiovascular,Fengshun People's Hospital,Meizhou 514300,Guangdong,CHINA)

机构地区：[1]丰顺县人民医院心血管内科,广东梅州514300

出　　处：《海南医学》2021年第6期685-688,共4页Hainan Medical Journal

基　　金：2019年度广东省梅州市社会发展科技计划项目(编号:2019B128)。

摘　　要：目的探讨经皮冠状动脉腔内切割球囊成形术(PTCBA)联合药物涂层球囊(DCB)扩张术治疗冠状动脉分叉病变的疗效及对患者血流心肌梗死溶栓试验(TIMI)分级的影响。方法选择2019年1月至2020年3月在丰顺县人民医院心血管内科治疗的80例冠状动脉分叉病变患者进行研究,按照随机数表法分为观察组和对照组各40例。两组患者均接受经皮冠状动脉介入术(PCI)治疗,对照组患者使用PTCBA联合普通球囊扩张分支病变,观察组患者使用PTCBA联合DCB扩张分支病变。比较两组患者术后即刻血流TIMI3级情况,术前、术后即刻及术后6个月时血管最小内径(MLD)和狭窄程度,术后6个月时晚期管腔丢失情况,并记录术后6个月期间主要心血管不良事件发生率。结果观察组患者术后即刻主支、分支病变TIMI3级的患者分别为92.50%、87.50%,对照组为85.00%、80.00%,两组比较差异无统计学意义(P>0.05);术后6个月时,观察组患者分支病变MLD为(2.31±0.20)mm,明显长于对照组的(2.11±0.29)mm,分支病变狭窄程度、分支病变晚期管腔丢失分别为(8.07±1.36)%、(0.07±0.02)mm,均明显低于对照组的(8.90±1.31)%、(0.20±0.06)mm,差异均有统计学意义(P<0.05);观察组患者靶血管再狭窄(主支及分支)、再发心绞痛、靶血管心肌梗死、靶血管血运重建的总发生率为5.0%,明显低于对照组的20.0%,差异有统计学意义(P<0.05)。结论PTCBA联合DCB扩张术治疗冠状动脉分叉病变的效果显著,术后血流TIMI分级满意,值得临床推广应用。Objective To study the effect of percutaneous transluminal coronary angioplasty(PTCBA)combined with drug coated balloon(DCB)dilation in the treatment of coronary bifurcation lesions and its effects on patients'blood flow Thrombolysis in Myocardial Infarction(TIMI)trail grade.Methods A total of 80 patients with coronary bifurcation disease,who admitted to Department of Cardiology,Fengshun People's Hospital from January 2019 to March 2020,were selected and divided into the observation group and control group according to random number table method,with 40 patients in each group.The two groups of patients all received percutaneous coronary intervention(PCI)treatment.The control group used PTCBA combined with common balloon dilatation,while the observation group used PTCBA combined with DCB dilatation.The blood flow TIMI3 grade at immediately after operation,the changes of the minimum internal diameter(MLD)and degree of stenosis at before operation,immediately after operation and 6 months after operation,the late lumen loss at 6 months after operation were compared between the two groups,and the incidence of major adverse cardiovascular events was recorded at 6 months after operation.Results The patients with TIMI grade 3 in the main branch and side branch lesions immediately after operation in the observation group patients were 92.50%and 87.50%,while those in the control group were 85.00%and 80.00%,with no significant difference between the two groups(P>0.05);at 6 months after operation,the MLD of side branch lesions in the observation group was(2.31±0.20)mm,which was significantly higher than(2.11±0.29)mm of the control group,and the degree of stenosis and late lumen loss of side branch lesions were(8.07±1.36)%,(0.07±0.02)mm,which were significantly lower than corresponding(8.90±1.31)%and(0.20±0.06)mm of the control group(P<0.05);the total incidence of target vessel restenosis(main branch and side branch),recurrent angina pectoris,target vessel myocardial infarction and target vessel revascularization in the

关 键 词：冠状动脉分叉病变 经皮冠状动脉腔内切割球囊成形术 药物涂层球囊 心肌梗死溶栓试验 不良心血管事件 

分 类 号：R654.2[医药卫生—外科学]